A nurse is monitoring a client admitted with an acute upper gastrointestinal hemorrhage. The client is increasingly restless. Current vital signs are blood pressure 108/86 mm Hg, heart rate 116 beats/min, and respiratory rate 28 breaths/min. Which of the following arterial blood gas (ABG) results represents the expected physiological adaptation during this specific phase of the client's condition?
- pH 7.49, PaCO2 30 mm Hg, HCO3- 23 mEq/LCevap
- BpH 7.28, PaCO2 36 mm Hg, HCO3- 16 mEq/L
- CpH 7.31, PaCO2 52 mm Hg, HCO3- 25 mEq/L
- DpH 7.42, PaCO2 40 mm Hg, HCO3- 24 mEq/L
Cevap
The arterial blood gas result demonstrating respiratory alkalosis (elevated pH and decreased PaCO2).
The client's vital signs indicate the early, compensatory stage of hypovolemic shock. This is evidenced by a narrowing pulse pressure (normal is 30-50 mm Hg; the client's is 22 mm Hg), tachycardia, and tachypnea. The rapid respiratory rate (28 breaths/min) causes a 'washout' of carbon dioxide, resulting in a decreased PaCO2 and an appropriately elevated pH. This state of respiratory alkalosis is the body's initial physiological adaptation to maintain oxygenation during acute blood loss.
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Anahtar Kavram
Compensatory mechanisms in early shock and their direct effect on arterial blood gas values.